Attachment 6a
Healthy Homes and Lead Poisoning Surveillance System (HHLPSS) Variables
(Includes CBLS Format: Tables 1-6 and ABLES Format: Table 7)
Form Approved
OMB No. 0920-0931
Exp. Date 05/31/2018
Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS)
Variables
The information requested on this form is collected under the authority of the Public Health Service Act [Section 301 (42 U.S.C. Section 241 and Section 247b-1 and 247b-3)]. Limited identifiable data (e.g., address or location) may be shared by the Awardees with the U.S. Department of Housing and Urban Development and the U.S. Environmental Protection Agency (and others) for the purpose of assessing compliance and enforcing regulations to protect children’s environments. Personally Identifiable Information (PII) are removed prior to quarterly submission to CDC.
Public reporting burden for this collection of information is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0931).
Required Fields Collected by Programs* |
*Personally Identifiable Information (PII) are removed prior to quarterly submission to CDC |
Individual-level Data (only for those with blood lead test) |
Last Name |
First Name |
Middle Initial |
ID |
DOB (actual) |
Age (reported from laboratory or provider) |
Sex |
Pregnant at time of test (if applicable) |
Previous country of residence |
Travel outside of US |
|
Demographic Data |
Ethnicity |
Hispanic/Latino |
Not Hispanic/Latino |
Race |
American Indian or Alaskan Native |
Asian |
Black or African American |
Native Hawaiian or Other Pacific Islander |
White |
Address Data |
Street Address |
Address ID |
City |
County FIPS |
State |
Zip Code |
Census Tract |
|
Blood Lead Test Data |
Specimen Source for lead test (sample type: venous blood, capillary blood, etc.) |
Date sample collected (Sample Date) |
Date sample analyzed (Sample Analyze Date) |
Laboratory result report date (Result Report Date) |
Numeric result comparator (less than, greater than) |
Numeric result value |
Numeric result units |
Explanation for missing numeric result (e.g., clotting, quantity not sufficient, etc.) |
|
Case Data |
Date case closed |
Closure reason |
Child Risk Assessment Data |
Investigation Data |
Referral date for investigation |
Date address investigation inspection completed |
Investigation findings of sources |
Investigation closure reason |
Date remediation due |
Date address hazard remediation or abatement completed |
Date clearance testing completed |
Clearance testing results |
|
Laboratory Data |
Name of Laboratory that reported test result |
Clinical Laboratory Improvement Amendment (CLIA) number |
Limit of Detection for blood lead testing |
|
Provider Data |
Provider/medical group State |
Provider/medical group City |
Provider/medical group County |
|
Healthy Homes Inspection Variables
(This Section includes inspectors’ assessment as well as questions home visitor would ask family in the course of the home visit, thus there are differences in formatting.)
Date of Inspection: _____________________
On what stories are household’s bedrooms located? Check all that apply
[ ] Basement
[ ] 1st Floor
[ ] 2nd Floor
[ ] Higher (Specify) ___________
How many people live in this household by age?
Children (< 6) __
Children (>= 6) __
Adults (18-64) __
Adults (>=65) __
Does anyone who lives in this home smoke?
(cigarettes, cigars, other tobacco products)
[ ] Yes
[ ] No
Do visitors to your home ever smoke in your home? Y N
Bathroom
Does bathtub/shower have non-slip surface?
[ ] Yes
[ ] No
Bathroom Exhaust
[] Exhaust fan not working or no exhaust fan or window present
[] Exhaust fan working
Ceiling, Floors and Walls
Bulging/Buckling
[ ] Bulging, buckling or alignment problem
[ ] No bulging, buckling or alignment problem
Holes
[ ] Large holes >= 8 ½ x 11 inches –OR- more than three tiles or panels missing –OR- there is a crack more than 1/8 inch wide and 11 inches long – OR – a hole penetrates the area above or adjacent
[ ] Medium-sized holes present: Holes less than 8 ½ inches x 11 inches in area. –OR- no hole penetrates the area above or adjacent. –OR- no more than three titles or panels missing.
[ ] Small holes present: Holes smaller than 8 ½ inches x ½ inches (do not count pinholes) in total hole area
Peeling/Needs Paint
[ ] >= 2 square feet damage: Peeling or deteriorated paint in any area larger than 2 square feet in any room.
[ ] < 2 square damage: Peeling or deteriorated paint in any area smaller than 2 square feet in any room.
[ ] No damage/peeling paint
Water Stains/Water Damage
[ ] >= 4 square feet water stains/water damage: Any one ceiling, floor, or wall has evidence of water stains/water damage, a leak (such as a darkened area) over a large area (4 square feet or more). Water may or may not be visible.
[ ] < 4 square feet water stains/water damage: Any one ceiling, floor, or wall has evidence of water stains/water damage, a leak (such as a darkened area) over a small area (less than 4 square feet). Water may or may not be visible.
[ ] No water stains/damage
Condensation on Windows
[ ] Condensation on windows, doors, walls
[ ] No condensation on windows, doors, walls
Mold
[ ] >= 4 square feet visible mold present: Any one ceiling, floor, or wall has visible mold over a large area (4 square feet or more)
[ ] < 4 square feet visible mold present: Any one ceiling, floor, or wall has visible mold over a small area (less than 4 square feet)
[ ] No mold observed.
Do you (inspector) smell a musty odor anywhere in the home?
[ ] Yes
[ ] No
[ ] n/a (cannot smell due to cold or other respiratory problem)
Electrical
Missing or Broken Electrical Covers
[ ] Exposed wiring: An open breaker port or exposed wiring
-OR-A cover is missing and electrical connections are exposed
[ ] None missing/broken/exposed
Child Tamper-resistant Outlet Covers
[ ] No tamper-resistant outlet covers in units with young children
[ ] Installed tamper-resistant outlet covers in units with young children
[ ] Not applicable (no young children in unit)
Extension Cord Use
[ ] Extension cords not used properly: Extension cords under carpets or across doorways -OR-Too many appliances plugged into one extension cord.
[ ] Extension cords used properly: Extension cords not draped across doorways or under carpets and not overloaded with too many appliances.
[ ] No extension cord use.
Extension Cord Condition
[ ] Not Good: Extension cords cracked or frayed
[ ] Good: Extension cords cracked or frayed
[ ] No extension cord use
Water Heater
Water Temperature
[ ] Temperature set at or above 120 degrees F
[ ] No hot water
[ ] Temperature set below 120 degrees F
In the past 6 months, has anyone been scalded by the water in this home?
[ ] Yes
[ ] No
Did this require medical attention?
[ ] Yes
[ ] No
Smoke and Carbon Monoxide Alarm
Smoke Alarm
[ ] Not operational: At least one smoke alarm tested does not work as designed.
[ ] No smoke alarms present: No smoke alarm in unit
[ ] Operational: All smoke alarms in unit work as designed.
CO Alarm
[ ] Not operational: At least one CO alarm tested does not work as designed
[ ] No CO alarm present
[ ] Operational: All CO alarms work as designed.
Stairs
Stair Railings
[ ] Missing: No handrails present or present on only one side
[ ] Broken or insecure: Handrail damaged, loose or otherwise unusable or insecure.
[ ] Does not apply: No steps.
[ ] Railings on both sides appear secure.
Steps: Condition
[ ] One or more broken or missing
[ ] Not broken or missing
[ ] Does not apply: No steps
Steps: Covering
[ ] No covering on stairs
[ ] Covering on stairs is not firmly attached or is poor condition
[ ] Covering on stairs (e.g.. nonslip tread covers) is firmly attached and is in good condition.
Stair Gates
[ ] not present at top or bottom of stair or not secured to wall
[ ] gate secured to wall at top or bottom but not both
[ ] gate secured to wall at top and bottom of stair
Lighting
[ ] light present at top and bottom of stairs
[ ] light not present at top or bottom
Windows
Window Condition
[ ] One or more windows missing
[ ] One or more windows cracked or broken
[ ] One or more windows cannot be opened
[ ] All windows intact and can be opened
Injury Hazards
For the purposes of this form, injury is defined as cuts, punctures, scrapes, bruises, fractures, or similar accidents. In the last 6 months, has any child had an injury or accident in the home that resulted in a visit for medical care?”
[ ] yes
[ ] no
[ ] not sure
[ ] n/a (no children)
ChildProofing Measures (if children age < 6 present in home)
Window Cords -Strangulation Hazard
[ ] Yes: Window cords looped or tied together
[ ] No: Window cords not looped or tied together
If yes hazard location:________
Window Guards >= 2nd floor
[ ] Missing or not operational
[ ] Present and operational
Chemicals, Pesticides, Cleaning Supplies or Medications Stored Within Easy Reach of Children.
[ ] Yes
[ ] No
Poisoning Hazards
Unvented Combustion Appliances
[ ] Yes
[ ] No
If Yes, please check all that apply:
[ ] fuel-fired space heaters
[ ] gas clothes dryers
[ ] gas logs
[ ] charcoal
[ ] stoves
Pest Hazards
Do you see evidence of cockroaches (bodies or fecal pellets)
[ ] Yes
[ ] No
[ ] Maybe
Do you see evidence of rodents (bodies, fecal pellets or gnaw marks)?
(HH_Pest_Hazards_Rodents)
[] Yes
[] No
Asthma
1) Has a doctor or other health professional EVER told you that [fill: S.C. name] had asthma?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children <6 years old
DURING THE PAST 12 MONTHS, has [fill: SC name] had an episode of asthma or an asthma attack?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: children <6 years old and doctor has informed that child had asthma
2) Has a doctor or other health professional EVER told you that [fill: S.C. name] had asthma?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: People ≥ 6 years old
DURING THE PAST 12 MONTHS.
DURING THE PAST 12 MONTHS, has [fill: SC name] had an episode of asthma or an asthma attack?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: People ≥6 years old and doctor has informed them they have asthma
CBLS Format for submitting de-identified data to CDC
Table: 1
Record Type: Basic Format
Position |
Field Name |
Valid Values - Description |
1-3 |
fileid |
File identifier for record type.
ADD - address data CHI - child INV - investigation LAB - lab LNK - child to address link HHI – healthy housing inspection |
4 |
action |
Database action code.
A - add record C - change/replace D - delete
|
5 |
qtr |
Reporting quarter. All annual submissions should be “4" for fourth quarter.
1 - first quarter (1/01/yy - 3/31/yy) 2 - second quarter (4/01/yy - 6/30/yy) 3 - third quarter (7/01/yy - 9/30/yy) 4 - fourth quarter (10/01/yy - 12/31/yy) |
6-7 |
rpt_yr |
Reporting year.
Last two digits of the reporting year. (Must be numeric.) |
8-12 |
pgmid |
Program identifier.
A unique identifier for the CLPPP (or lead database) submitting the data. The first two positions must contain the state FIPS (Federal Information Processing Standard) code. The next three positions are pre-assigned for STELLAR databases and must be unique for each lead database within a state (including databases other than STELLAR). You may obtain a program ID from the Lead Poisoning Prevention Branch (LPPB). |
13-20 |
child_id |
Child identifier.
A unique identifier for a child; must be numeric and zero-filled. This would generally be a system-assigned sequential number within a database. The identifier is used in relational databases to eliminate redundant data. The child information exists only once, in one physical record, and is linked to related records by the child identifier.
When records from two or more databases are combined, the combination of pgmid and child_id form a unique identifier within the combined database. |
13-20 |
addr_id |
Address identifier.
A unique identifier for an address; must be numeric and zero-filled. This would generally be a system-assigned sequential number within a database. The identifier is used in relational databases to eliminate redundant data. The address information exists only once, in one physical record, and is linked to related records by the identifier.
When records from two or more databases are combined, the combination of pgmid and addr_id form a unique identifier within the combined database. |
21-249 |
All_the_rest |
A variable format area. The contents and format depend on the value in the field fileid. |
Table: 2
Record Type: Address
FileId: ADD
Position |
Field Name |
Valid Values - Description |
1-12 |
|
Basic format as illustrated in Table 1. REQUIRED |
13-20 |
Addr_id |
See Table 1. REQUIRED |
21-35 |
City |
City name. |
36-38 |
cnty_fips |
County FIPS code. REQUIRED
Numeric, zero-filled. A file of counties and assigned FIPS codes is available from Lead Poisoning Prevention Branch. |
39-47 |
Zip |
Zip code (5+4 format, no dash).
Left justified, blank-fill or zero-fill. |
48-49 |
State |
State abbreviation. |
50-56 |
census |
Census tract.
Left justified, blank-fill. |
57 |
renovated |
Residence renovated?
1 - yes, once 2 - no 3 - yes, more than once 9 - unknown |
58-65 |
start_ren |
Date first renovation begun. (CCYYMMDD) Date must be present when renovated field (col 57) is coded 1 or 3. Date must be blank when renovated field is coded 2 or 9. |
66-73 |
Comp_ren |
Date latest renovation completed. (CCYYMMDD) Cannot be earlier than start_ren date. Leave blank if renovation is ongoing as of the end of the reporting year. |
Table: 3
Record Type: Child
FileId: CHI
Position |
Field Name |
Valid Values - Description |
||||||||||||||
1-12 |
|
Basic format as illustrated in Table 1. REQUIRED |
||||||||||||||
13-20 |
Child_id |
See Table 1. REQUIRED |
||||||||||||||
21-28 |
Dob |
Child's date of birth. (CCYYMMDD) REQUIRED Birth date cannot be after the end of the reporting year. Child may not be older than 16 years at the start of the reporting year. |
||||||||||||||
29 |
gender |
1 - male 2 - female 9 - unknown |
||||||||||||||
30 |
ethnic |
(Select only one) 1 – Hispanic/Latino 2 - Not Hispanic/Latino |
||||||||||||||
31 |
race
|
|
||||||||||||||
32 |
chelated |
1 - Yes 2 - No 9 - Unknown |
||||||||||||||
33 |
chel_type |
1 - Inpatient 3 - Both 2 - Outpatient 9 - Unknown Cannot be blank if chelated field =1. Cannot be 1, 2 or 3 if chelated =2 or 9. |
||||||||||||||
34 |
fund_source |
1 - Public, includes Medicaid 8 - Other 2 - Private insurance 9 - Unknown 3 - Parent self-pay Cannot be blank if chelated field = 1 or 9. |
||||||||||||||
35 |
Nplsz |
Non-paint lead source - other. 1 - Yes 2 - No 9 - Unknown |
||||||||||||||
36 |
Nplsm |
Non-paint lead source - traditional medicines. 1 - Yes 2 - No 9 - Unknown |
||||||||||||||
37 |
Nplso |
Non-paint lead source – occupation of household member. 1 - Yes 2 - No 9 - Unknown |
||||||||||||||
38 |
Nplsh |
Non-paint lead source - hobby of household member. 1 - Yes 2 - No 9 - Unknown |
||||||||||||||
39 |
Nplsp |
Non-paint lead source - pottery, imported or improperly fired 1 - Yes 2 - No 9 - Unknown |
||||||||||||||
40 |
Nplsc |
Non-paint lead source - child occupation. 1 - Yes 2 - No 9 - Unknown |
Record Type: Investigation
FileId: INV
Position |
Field Name |
Valid Values - Description |
1-12 |
|
Basic format as illustrated in Table 1. REQUIRED |
13-20 |
addr_id |
See Table 1. REQUIRED |
21-28 |
date_ref |
Date address referred for investigation. (CCYYMMDD) REQUIRED |
29-36 |
insp_comp |
Date address investigation inspection completed. (CCYYMMDD) May not be prior to date_ref. |
37-44 |
abat_comp |
Date address hazard remediation or abatement completed. (CCYYMMDD) May not be prior to insp_comp. |
45-48 |
Year |
Year the dwelling was constructed. (YYYY) Blank if unknown. May not be after reporting year. |
49 |
ownership |
1 - Private, owner-occupied 4 - Rental, Section 8 2 - Rental, privately owned 9 - Unknown 3 - Rental, publicly owned |
50 |
dwell_type |
1 - Attached, single family 5 - School 2 - Day care center 8 - Other 3 - Detached, single family 9 - Unknown 4 - Multi-unit |
51 |
paint_haz |
Dwelling with peeling, chipping, or flaking paint. (Must be 9 if insp_comp is blank.) 1-Yes, interior 3-Yes, both 9 - Not inspected 2-Yes, exterior 4 - No |
52-56 |
Xrf |
Highest XRF reading in mg/cm2. (000.0) See Note below. |
57-64 |
dust_floor |
Highest floor dust sample reading. (000000.0) See Note below. |
65 |
floor_msr |
Unit of measure. U - g/ft2 Cannot be blank if dust_floor >0. P - ppm |
66-73 |
dust_sill |
Highest window sill dust sample reading. (000000.0) See Note below. |
74 |
sill_msr |
Unit of measure. U - g/ft2 Cannot be blank if dust_sill >0. P - ppm |
75-82 |
dust_well |
Highest window well dust sample reading. (000000.0) See Note below. |
83 |
well_msr |
Unit of measure. U - g/ft2 Cannot be blank if dust_well >0. P - ppm |
84-91 |
Paint |
Highest paint chip sample reading. (000000.0) See Note below. |
92 |
paint_msr |
Unit of measure. U - g/ft2 Cannot be blank if paint >0. P - ppm M - mg/cm2 |
93-100 |
soil |
Highest soil sample reading in ppm. (000000.0) See Note below. |
101-108 |
water |
Highest water sample reading in ppb. (000000.0) See Note below. |
109 |
indhaz |
Industrial hazard near dwelling. 1 - Yes 2 - No 9 – Unknown |
Note: Environmental sample results should all be shown right-justified, zero-filled on the left, and formatted with one decimal position. If no decimal value, format with decimal and zero (000500.0).
Table: 5
Record Type: Lab Results
FileId: LAB
Position |
Field Name |
Valid Values - Description |
1-12 |
|
Basic format as illustrated in Table 1. REQUIRED |
13-20 |
child_id |
See Table 1. REQUIRED |
21-28 |
samp_date |
Date sample was drawn. (CCYYMMDD) REQUIRED May not be prior to child date of birth. |
29-36 |
addr_id |
Unique identifier of child's primary address on the date sample was drawn. (See Table 1.) Zero-fill if unknown. |
37-39 |
result |
Sample result measured in g/dL. Whole number, zero-filled. REQUIRED |
40 |
fund_source |
Source of funding for the test.
1 - Public, includes Medicaid 2 - Private insurance 3 - Parent self-pay 8 - Other 9 - Unknown |
41 |
samp_type |
Sample type. 1 - Venous, blood lead 2 - Capillary, blood lead 9 - Unknown |
42 |
test_rsn |
Test reason.
1 - Screening (asymptomatic child without previous elevated level) 2 - Clinical suspicion of lead poisoning (child symptomatic) 3 - Confirmatory test following elevated value by fingerstick 4 - Follow-up, child with confirmed elevated level 5 - EP, not for lead-screening 9 - Unknown/other
|
43 |
lab_type |
Type of laboratory processing sample. 1 - Public health laboratory 2 - Commercial laboratory 9 - Unknown |
44 |
scrn_site |
Type of provider ordering test, or screening site.
1 - CLPPP fixed-site specific to lead 2 - Door to door program 3 - Other fixed-site screening program, e.g. WIC 4 - Private health care provider 5 - Referred for confirmation, no screening information 9 - Unknown/other |
45 |
medicaid |
1 - Yes 2 - No 9 - Unknown |
46-53 |
samp_anaz_dt |
Date sample analyzed by lab. (CCYYMMDD) May not be prior to samp_date. |
54-61 |
rslt_rpt_dt |
Date results reported to/received by health department. (CCYYMMDD) May not be prior to samp_date. |
Table: 6
Record Type: Child to address link (Optional record type)
FileId: LNK
Field Name |
Valid Values - Description |
|
Basic format as illustrated in Table 1. REQUIRED |
child_id |
Unique child identifier. See Table 1. REQUIRED |
addr_id |
Unique address identifier. See Table 1. REQUIRED |
type_addr |
1 - Primary address 2 - Relocation address 3 - Alternative 4 - Supplemental 9 – Unknown |
first_occ |
Date the child first occupied or began spending time at address. (CCYYMMDD) REQUIRED May not be after the end of the reporting period. |
last_occ |
Date the child moved from or ceased spending time at address. (CCYYMMDD) May not be prior to first_occ date. |
NOTE: There should be only one "open" link record per child (last_occ is blank) where address type code is 1 or 2; A relocation address is considered a primary address to which a child has been permanently moved to remove them from a hazardous environment.
Table 7. Format for Adults with blood lead test
|
|||
1. StateRep |
2 |
Text |
2-letter Postal State abbreviation for the State making this report. [Note: This should be a constant and must be present] |
2. StateRes |
2 |
Text |
2-letter Postal State abbreviation for State in which the adult resides. 99 = Unknown. CN = Canada, MX = Mexico. |
3. CountyRes |
3 |
Text |
3-digit county Federal Information Process Standards (FIPS) code for county of residence of the adult. 999 = Unknown. |
4. StateExp |
2 |
Text |
2-letter Postal State abbreviation for State where exposure occurred. 99 = Unknown. CN = Canada, MX = Mexico. [Note : Code StateExp only if you are sure of exposure location (do not make assumptions)] |
5. CountyExp |
3 |
Text |
3-digit county FIPS code for county where exposure occurred. 999 = Unknown. |
6. ID |
15 |
Text |
State-assigned unique ID number for adult (ID must remain constant from year to year) with 15 characters maximum. If all characters are not used, leave the missing ones blank, and left justify. Do not fill with zeros. [Note: Do not use any personal identifier such as an SSN or name for ID.] |
7. Status |
1 |
Text |
For adults with BLLs ≥10 µg/dL: 1 = New case. An adult whose highest BLL was ≥10 µg/dL in the current calendar year who was not in the State lead registry in the immediately preceding calendar year with a BLL ≥10 µg /dL. This adult may have been in the registry with a BLL ≥10 µg /dL in earlier calendar years or with a BLL <10 µg /dL in the immediately preceding calendar year. [Note: A new case should remain coded 1 for all other BLL tests for the adult done in the same calendar year.]
2 = Existing case. An adult whose highest BLL was ≥10 µg /dL in the current calendar year who was in the registry in the immediate preceding calendar year with a BLL ≥10 µg /dL.
9 = Unknown
For adults with BLLs <10 µg/dL: 3 = Unclassified Adult. An adult whose highest BLL was <10 µg/dL about whom you have collected insufficient information to determine whether he/she is a new or existing adult in the State registry.
4 = New adult. An adult whose highest BLL was <10 µg/dL who was not in the State lead registry in the preceding calendar year with a BLL either less than or greater than 10 µg/dL. This adult may have been in the registry in earlier years.
5 = Existing adult. An adult whose highest BLL was <10 µg /dL who was in the registry in the preceding calendar year with a BLL either less than or greater than 10 µg/dL. [Note: Codes 3-5 are provided to facilitate the reporting of the lower BLLS. The use of Code 3 should be rare as should the use of Code 9.] |
8. BLLDate |
10 |
Date |
Date blood drawn or date of lab BLL test. MM/DD/YYYY [Note: Change short date under control panel/regional options to reflect MM/DD/YYYY.] |
9. DateType |
1 |
Text |
1 = Date of blood draw (preferred) 2 = Date of laboratory test (acceptable) 3 = Date of health department ascertainment (acceptable) 9 = Unknown |
10. BLL |
3 |
Numeric |
Blood lead level, 3 digits no decimal, leave blanks, right justify. |
11a. DOB |
10 |
Date |
Date of Birth (MM/DD/YYYY) [Note: If DOB unavailable, you may leave blank and code Age] |
11b. Age |
3 |
Numeric |
Age in years, right justify, no decimal. 999 = Unknown [Note: If DOB provided, you may leave Age blank] |
12. Sex |
1 |
Text |
1 = Male 2 = Female 3 = Other 9 = Unknown |
13. Ethnicity |
1 |
Text |
1 = Yes (Hispanic/Latino) 0 = No (Not Hispanic/Latino)
|
14. Race |
1 |
(More than one can be marked) American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White |
|
15. WorkRel |
1 |
Text |
This is your determination on whether the exposure was work related. 1 = Work related 2 = Not work related 3 = Both 9 = Unknown [Note: Code 1, 2 or 3 only if you are sure of the exposure source. Code 9 if you do not know — do not make assumptions.] |
16. NAICS |
6 |
Text |
North American Industry Classification System 2002 999 = Unknown [Note: If WorkRel is coded 1 or 3, NAICS should have a valid code or 999. If WorkRel is coded 2 or 9, NAICS should be blank.]
http://www.census.gov/eos/www/naics/
|
17. COC |
4 |
Text |
Census Occupation Codes 2002 990 = Unknown [Note: If WorkRel is coded 1 or 3, COC should have a valid code or 990 If WorkRel is coded 2 or 9, COC should be blank]
http://www.census.gov/people/io/
|
18. Process |
50 |
Text |
Process is defined as a narrative of the non-occupational avocation or activity from which the adult was exposed to lead.
NA = Non-applicable. [Note: If WorkRel is coded 2 or 3, Process should have a narrative entry, a code, or 999.] [Note: If WorkRel is coded 1 or 9, Process should be coded NA.]
[Note: While it is acceptable to use the following codes for the most frequent process categories, we prefer that you include text descriptions so that the need for new categories or new exposures can be assessed.]
1 = Shooting firearms (target shooting) 2 = Remodeling/renovation/painting 3 = Casting (e.g., bullets, fishing weights) 4 = Ceramics 5 = Stained glass 6 = Retained bullets (gunshot wounds) 7 = Pica (the eating of non-food items) 8 = Eating from leaded cookware 9 = Eating food containing lead (e.g., imported candy) 10 = Drinking liquids containing lead (e.g., moonshine) 11 = Taking nontraditional medicines (e.g., Ayurvedic medications) 12 = Retired (This could be a former lead worker; try to get SIC, NAICS) 13 = Other--please provide text descriptions for sources not listed above. 999 = Unknown
|
Note: Variable formats may change to meet emerging CDC guidelines for surveillance systems.
NOTE: The following website is most useful in finding help in coding industry: (1) Search by a keyword in the line of business the adult is in and it will find the NAICS code. (2) Search by SIC code and it will find the corresponding NAICS code. (3) Search by the NAICS code to receive the full description.
http://www.census.gov/eos/www/naics/
File Type | application/msword |
File Title | Fields CLPPPs must submit to CDC quarterly |
Author | pfm7 |
Last Modified By | SYSTEM |
File Modified | 2018-05-14 |
File Created | 2018-05-14 |